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'kids' Parentelligence posts

Summer has ended, the kids are back in school, and fall is officially here. Which means….cold and flu season is upon us! Hospitals are already seeing documented cases of seasonal influenza. There are no known cures for colds and flu, so cold and flu prevention should be your goal.

Why do we care about preventing influenza? The flu can be very dangerous for children, causing illness, hospital stays and death each year. The CDC (Center for Disease Control) reports about 20,000 children below the age of 5 are hospitalized from flu complications each year.

The most effective way for preventing the flu is to get the flu shot. It works better than anything else. (Flu vaccination is recommended for all children aged 6 months and older). There are additional strategies you can employ to help ward off those nasty viruses.

Bedwetting (also called nocturnal enuresis) is a very common childhood problem. The number of children with this problem varies by age. For example, at five years of age, an average of 16% of children will have a bedwetting accident. By 15 years of age and older, 1-2 % continue to wet the bed. For most children, this will improve or resolve without any treatment as they get older.

What can cause bedwetting?

Bedwetting may be related to one or more of the following:

The child’s bladder holds a smaller than normal amount

Genetics (parents who had nocturnal enuresis as a child are more likely to have children with the same concern)

Diminished levels of vasopressin (a hormone that reduces urine production at night)

The mechanism for the bladder and brain to talk to each other is “off line”

It is important that children develop healthy eating habits early in life. Here are some ways to help your child eat well and to make meal times easier.

What to Expect:

After the first year of life, growth slows down, and your child's appetite may change.

It's normal for your child to eat more on some days and very little on other days.

A child may refuse to eat in order to have some control in his life.

A child may be happy to sit at the table for 15 to 20 minutes and no longer.

A child may want to eat the same food over and over again.

How can I encourage my child to eat more?

Set regular meal and snack times. Avoid feeding your child in between these times, so that they are hungry at meal and snack times. If you want your child to eat dinner at the same time you do, try to time his snack-meals so that they are at least two hours before dinner.

Limit juice and milk between meals. Offer water between meals, which will satisfy thirst without spoiling the appetite. Serve drinks at the end of the meal.

Respect tiny tummies. Keep portion sizes small. Here's a rule of thumb – or, rather, of hand. A young child's stomach is approximately the size of his fist. A good serving size for a young child is 1/2 slice of bread, 1 oz of meat, or 1/4 cup of fruit or vegetable pieces.

As I work with the families of children diagnosed with IBD, I am constantly amazed at what a complicated job they have, balancing life between a chronic illness and the challenges of “normal childhood”.

As the school year gets off to a start, seeing how hectic life can become for most kids, I wanted to write down a few ways children with IBD might better empower themselves to gain control over their chronic disease:

I remember one day during my pediatric gastroenterology fellowship, a mother and child were walking in front of my professor and me, as we made our daily rounds in the hospital. When the pacifier fell out of the toddler’s mouth and the mother picked it up and put it right back into the child's mouth, my professor remarked to me, "mark my words....that child will never get Crohn’s disease!" My professor was referring to the theory of the "Hygiene Hypothesis". This theory is thought to explain (at least in part) why so many more people in developed nations become afflicted with autoimmune diseases such as Inflammatory Bowel Disease (IBD - Crohn's disease and Ulcerative Colitis) as well as food allergies, compared to people in non-developed nations.

The last days of summer are counting down! Here are some timely tips to help ensure the school year goes well.

To and From School Safety:

The school bus is a great way for children to get to school. To ensure safety, make sure young children are supervised at bus stops. Parents trust bus drivers to keep our kids safe, therefore it is very important for children to know and follow bus safety rules.

Carpooling? Buckle up! The American Academy of Pediatrics recommends that children ride in a booster until the seat belt fits correctly, typically when they are 4’9” (age 8-12). Use the seat belt fit test to determine if your child still needs a booster. (For safety reasons, it is against the law in Washington for a child under 13 to ride in the front seat.)

Supervise young children and make sure well-fitted helmets are worn when riding a bike, scooter, or skateboard. And, don’t forget to review pedestrian safety rules for when they are commuting.

In case of unforeseen circumstances, ensure your child knows your phone number and address. An ID with this information in your child’s backpack can be helpful in case of emergency. (A review of “stranger danger” is also a good idea.)

Food allergies have been on the rise in recent years. Studies suggest that up to 1 in 13 children are affected by a food allergy. Egg and cow’s milk are the most common food allergies for infants and toddlers. Fortunately, most children will lose a milk or egg allergy by the time they enter school. Peanut and tree nut allergies are also becoming more common. Unfortunately, only 10-20% of children will ever outgrow a nut allergy.

Currently there is no cure for food allergies. Instead, doctors rely on an accurate diagnosis, avoiding food triggers, and being prepared in the event of a severe reaction. Making the situation more challenging, nearly half of children with a food allergy may be at risk for a potentially life-threatening reaction called anaphylaxis.

Symptoms of anaphylaxis may include:

hives or itchy welts

swelling

vomiting or diarrhea

difficulty breathing (cough, wheeze or shortness of breath)

dizziness or passing out

During a severe food allergy reaction, epinephrine (“adrenaline”) can be a life-saving medication. Epinephrine is typically injected into a thigh muscle with an “auto-injector” device like EpiPen® or Auvi-Q™. Oral antihistamines like Benadryl, Allegra, or Zyrtec can help with some anaphylaxis symptoms, but are not considered life-saving treatment.

Emergency Epinephrine in Schools

Until recently, only certain students in Washington State could receive a life-saving epinephrine injection while at school. They needed to be diagnosed with a food allergy and already have an epinephrine injector in the health room. However, some students may not have an injector at school, or they have their first serious allergic reaction while at school. In that case, the school could only call 911 and hope they arrived in time to save a life.